Onkológia 3/2021

Current local treatment options of recurrent nasopharyngeal carcinoma

Locally recurrent nasopharyngeal carcinoma (rNPC) represents a challenging therapeutic scenario in the clinical practice. Due to the vulnerability of the heavily pretreated neurological structures anatomically surrounding the nasopharynx, any potentially curative treatment option (surgery, reirradiation) bears a significant risk of severe complications that may lead to a high treatment-related morbidity and quality of life deterioration. Yet with careful patient selection, long-term survival can be achieved in a subset of patients with rNPC. Early detection of the recurrence is crucial for the therapeutic success and in the case of early detection of the disease, the patient can be offered several treatment options with a curative intention; albeit with minimal support in prospective clinical data. The aim of this review is to summarize the currently available evidence on modern surgical treatment and reirradiation of rNPC. Both approaches have been scientifically explored, yet there is no consensus on a definitive preference of a particular type of salvage treatment. The final decision-making on the treatment approach is largely dependent on the availability of the particular surgical or reirradiation techniques across the institutions.

Keywords: nasopharyngeal carcinoma, recurrence, nasopharyngectomy, reirradiation, external beam radiotherapy, brachytherapy